Today I’m talking about testing and evaluation. When I talk about this, I’m thinking about the general idea of using evidence-based tests to provide data on neurological, psychological and physiological functioning. Testing also might include blood tests, sleep tests, psychological testing or neuropsychological testing. 

One or more of these is recommended when there’s a lack of clarity in underlying causes. Clinicians often see symptoms (like poor concentration or lack of motivation) and immediately jump to solutions or interventions (eg. medication or therapy). But without understanding the root cause (or at least our best working hypothesis), we may waste time and money treating the wrong thing. In some cases, we risk making things worse. For example, there are some instances where a college student struggling with depressive symptoms might be in therapy and taking antidepressants but have made no progress – maybe even getting worse. With a blood test, we might discover they have an underlying autoimmune disease that affects the thyroid (like hypothyroidism) which in turn mimics (or causes??) depressive symptoms. In some studies, use of antidepressants actually was found to sometimes cause hypothyroidism. 

Same holds true with sleep studies that may find undiagnosed sleep problems that are caused or correlated with mood, cognitive function and energy levels.  

Psychological testing is often seen as mysterious, subjective and more like a ouija board when in fact it’s actually quite the opposite. First of all, there is no ‘one’ psych test. Psych testing refers to the general category of using evidence-based batteries to collect data on an individual’s mood, cognition, personality and IQ. 

There are nine major types of psych tests – 

Personality Tests

Achievement Tests

Attitude Tests

Aptitude Tests

Emotional Intelligence Tests

Intelligence Tests

Neuropsychological Tests

Projective Tests

Observation (Direct) Tests

Within these nine types, there are dozens of batteries and tests that a psychologist might depending upon what the symptoms and goals are. Some psych testing is used in K-12 for IEPs and 504s, but that’s mostly looking at cognitive ability. For college students, psych testing primarily focuses on mood, thought processing and brain functioning. 

Psych testing helps direct the therapist what to focus on and what specific interventions are likely to be more effective. It’s like taking your car to the dealership after hearing a pinging noise from the engine. They hook it up to the computer, run diagnostics, and come up with a solution. The mechanic then knows what parts, tools and timeline is necessary to get the car back to good functioning condition. 

When there is concern of a brain injury or other stuff wrong with the hardware, we use batteries that focus primarily on the neuropsychological data. This is typically what we call neuropsychological testing. Neuropsych testing is conducted by psychologists with special training in memory, language, executive functioning, dementia, visuospatial Function, and brain regions. A good example of how this can be helpful is when there’s an undiagnosed and maybe even minor injury to the front of the head which affects the prefrontal cortex (that big chunk of brain behind your forehead). This is the executive functioning center. When it’s damaged, we might see poor planning and organization. Neuropsych testing can pinpoint regions of the brain that might have injury or atypical functioning which can in turn dictate areas for intervention such as biofeedback. 

A more common form of assessment goes by a few different names but are essentially the same. A clinical intake assessment, also known as the biopsychosocial assessment, collects objective (eg. medications/dosages) and subjective (eg. list of stressors) information that clinicians use to determine which clinician might provide the most congruent personality and skill set while also starting the process of a clinical treatment plan if necessary. These assessments are used by therapists, social workers and residential treatment programs when clients first start treatment. 

There are also career and personality assessments which, while not evidence-based, provide helpful insights into interests, personality and skills. For our purposes today it’s enough to understand that these assessments are more for novelty and expanding a college student’s understanding of themself and what career areas might be most suitable. Career assessments are in no way to identify or explain emotional or cognitive challenges though large employers will often have employees complete similar tests in an attempt to help employees find the best fit inside of the company. 

That’s it for this episode on testing and assessments. Check out my book (Insider’s Guide to Parenting: How to Solve Messy Problems and Build a Great Family) that took a deeper dive into psychological testing.